To evaluate the quality of remote semen collection and a smartphone-based semen analysis system under real-world conditions compared to a laboratory assessment among participants who were unselected for fertility status.
Prospective study SUBJECTS: 150 men unselected for fertility status who participated in the Reproductive Effects of Chemicals and Air Pollution (RECAP) study.
Participants performed remote smartphone-based semen analysis and sent samples to a fertility center laboratory.
Agreement of sperm concentration and motility using a smartphone-based analyzer and delayed evaluation in the andrology laboratory.
Of 150 men who provided a semen sample analyzed remotely or at the laboratory, 92 participants had both usable smartphone and delayed Computer Assisted Sperm Analysis (CASA) results. The median time (IQR) between semen collection and delayed laboratory assessment was 29.9 (26.5, 32.3) hours. The median sperm concentration was 83.0 million/ml by smartphone and 50.7 million/mL by delayed CASA assessment. The median total motility was 36.5% by smartphone and 4.5% by delayed laboratory assessment. Bland-Altman plots comparing the smartphone analyzer to delayed laboratory assessment for sperm concentration and total sperm count suggest that differences between the two methods were higher as sperm concentration increased. Smartphone-based measures were highly reproducible for concentration (ICC=0.98) and motility (ICC=0.90). Smartphone-based systems had high specificity (86.2%) and negative predictive value (93.8%) for identifying men with low sperm concentration (<16 million/ml, n=5) by laboratory assessment. There was a suggestion that sperm motility based on the smartphone assessment was inversely associated with the probability of having no motile sperm in the delayed laboratory assessment.
Smartphone-based systems are a comparable option to a single laboratory-based CASA measurement and have logistical advantages for research studies and potentially as a clinical screening tool among men in the general population. Further studies are warranted to confirm their effectiveness and broader utility.
Fertility and sterility. 2025 Jul 10 [Epub ahead of print]
Makiko Mitsunami, Hemanth Kandula, Anjali Devi Sivakumar, Tejas Girish Deshpande, Jasmine Kumar, Susitra Gnanasambhandam, Prudhvi Thirumalaraju, Manoj Kumar Kanakasabapathy, Charles L Bormann, Martin Kathrins, Hadi Shafiee, Jorge E Chavarro, Jaime E Hart
Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States., Brigham and Women's Hospital- Harvard Medical School, Division of Engineering in Medicine- Department of Medicine, Boston, Massachusetts, United States., Massachusetts General Hospital- Harvard Medical School, Division of Reproductive Endocrinology & Infertility- Vincent Department of Obstetrics & Gynecology, Boston, Massachusetts, United States., Mass General Brigham, Department of Urology, Harvard Medical School, Boston, Massachusetts, United States., Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States; Brigham and Women's Hospital- Harvard Medical School, Channing Division of Network Medicine- Department of Medicine, Boston, Massachusetts, United States. Electronic address: ., Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States; Brigham and Women's Hospital- Harvard Medical School, Channing Division of Network Medicine- Department of Medicine, Boston, Massachusetts, United States. Electronic address: .